OXYGEN ADMINISTRATION

Oxygen administration is a therapy to maintain adequate tissue oxygenation while

minimizing cardiopulmonary work.
PURPOSE
 To maintain the oxygen tension in blood plasma
 To increase the oxy hemoglobin in red blood cells
 Maintenance of oxygenation while providing anesthesia,
 Treatment of headaches,
 Carbon monoxide exposure
ARTICLES USED FOR OXYGEN ADMINISTRATION
 oxygen source - oxygen cylinder/central supply
 Oxygen application device - oxygen face mask, oxygen hood, nasal pongs, nasal
catheters, oxygen tent or canopy.
 Humidifier
 Flow meter
 Gauze pieces
 Adhesive tapes
 Spanner to remove main valve of oxygen supply
 Bowl with water to check the patency the tub
 Simple face mask
 Venturi system
 Nasal cannulae
 Reservoir mask
 High flow oxygen
 Face Mask
METHODS OF OXYGEN ADMINISTRATION
Administration of oxygen by nasal catheter
1. A nasal cannula is generally used wherever small amounts
of supplemental oxygen are required, without rigid control
of respiration, such as in oxygen therapy.
2. Most cannulae can only provide oxygen at low flow rates up
to 5 litres per minute (L/min) delivering an oxygen
concentration of 28–44%.
Administration of oxygen by mask
1. Connect face mask to oxygen source. Turn on the oxygen at the prescribed rate.
2. Adjust flow rate.
3. Allow oxygen to fill the bag. Place mask on face, applying from the nose and over the
chin.
4. Oxygen mask applied over nose and mouth.
5. Adjust elastic strap.

Administration of oxygen by tent method

1. An oxygen tent consists of a canopy placed over the head and shoulders, or over the
entire body of a patient to provide oxygen at a higher level than normal.
2. Some devices cover only a part of the face.
3. Assess the client for obstruction of the nasal passages by observing of breathing patterns.
4. Adjust the flow rate to the prescribed amount.
5. Gently position nasal prongs into client’s nares, with curves of prongs pointing toward
the floor of the nostrils.
PROCEDURE
1. Verify written order for oxygen therapy, including methods of delivery and flow rate.
2. Wash hands.
3. Explain the procedure to client.
4. Assess the client for obstruction of the nasal passages by observing of breathing patterns.
5. If using a wall outlet as oxygen source, plug flow meter into outlet by pushing until it
snaps into place.
6. Adjust the flow rate to the prescribed amount.
7. Gently position nasal prongs into client’s nares, with curves of prongs pointing toward
the floor of the nostrils.
 8. Loop the cannula tubing over the client’s ears; adjust the fit of the tubing by sliding the
adjuster upward to hold the cannula in place
9. Assess the client’s nares, face, and ears every 4 hours for signs of skin irritation or
breakdown and document of findings. At the same time, inspect the nasal prongs for the
presence of nasal secretions or crusts. If needed, wife the prongs clean with a gauze pad.
COMPLICATIONS OF OXYGEN ADMINISTRATION
1. Infection
2. Dryness of mucous membrane of respiratory tract.
3. Combustion (fire)
4. Oxygen toxicity
5. Atelectasis
6. Oxygen induced apnea
7. Asphyxia

BACK CARE
Back care consists of cleaning and massaging back (from shoulder to lower level of the
buttocks) by using scientific form of required strokes for maximizing cutaneous stimulation,
comfort and emotional relaxation as well.
PURPOSES
 To relieve muscle tension
 To promote physical and mental relaxation.
 To relieve insomnia
 To stimulate blood circulation
 To assess the condition of skin
 To prevent bedsore
INDICATIONS
 Mobilization of intertissue fluids.
 Reduction or modification of edema.
 Increase of local blood flow.
 Decrease of muscle soreness and stiffness.
 Moderation of pain.
 Facilitation of relaxation.
 Prevention or elimination of adhesions.
ARTICLES
 Lotion or oil
 Bath towel
 Bath blanket
 Soap
 Wash cloth
 Warm water in basin
 Mackintosh and draw sheet
MASSAGE TECHNIQUES
 Effleurage-Circular stroking movements.
 Petrissage-Kneading movements.
 Friction-Rubbing Strokes.
 Vibration-Shaking movements to loosen the body.
 Tapotement-Tapping.
Effleurage
Effleurage is a massage therapy technique which encourages waste products to leave the body
via the lymphatic system.

Petrissage
The thumbs and the knuckles of the fingers are used to knead the muscles of the body and to
squeeze them to prepare them for the other massage techniques that follow.

Friction
The palms of the hand are rubbed together vigorously with each other, or they are rubbed
onto the skin of the person being massaged in order to produce heat by friction.
Vibration or Shaking
This helps to loosen up the muscles by using a back and forth action of the fingertips or
the heel of the hand over the skin. The muscles of the body are literally shaken up to loosen and
relax the muscles.
Tapotement or Rhythmic Tapping
As the name suggests, it consists of rhythmic tapping that uses the fists of the cupped hands.
This helps to loosen and relax the muscles being manipulated and also helps to energize them.
PROCEDURE
 Explain the procedure and the position to the patient.
 Close curtains around bed. Lower the side rails and help patient assume prone or side
lying position (sim’s position)
 Expose patient’s back, shoulders, upper arms, and buttocks. Cover remainder of body.
 Wash hands with warm water.
 Apply hands first to sacral area massaging in circular motion, stroke upwards from
buttocks to shoulders
 Continue in one smooth stroke from upper back to arm and laterally alongside of back,
down to iliac crest.
 Continue massage pattern effleurage for at least 3 minutes.
 Perform petrissage along upward along one side of spine from buttock to shoulders.
 Perform tapotement for 2 minutes.
 Apply other remaining massaging techniques for at least 2 minutes.
 Apply oil or lubricants to back as required.
 Wipe excess lubricant from patients back with bath towel/ tissue.
 Help patient to comfortable position. Raise side rails as needed
 Record response to back massage and condition of skin.
COMPLICATIONS
 Diabetes.
 Cardiovascular disease.
 Arthritis.
 Obesity.
 BATHING
Bathing is the washing of the body with a liquid, usually water or an aqueous solution, or
the immersion of the body in water.
TYPES OF BATH
1. Complete bed bath
2. Partial bed bath
3. Tub bath
4. Shower bath
5. Sitz bath
6. Sponge bath
7. Shampoo bath/care
8. Bathroom bath
COMPLETE BED BATH AND PARTIAL BED BATH
A complete bed bath indicates that someone must totally wash a patient, as is done with
an unconscious patient. A partial bed bath is one in which the patient is not totally dependent but
is given a basin, soap, and water, as well as any assistance needed to maintain good hygiene.
A complete bed bath involves washing the entire body. A partial bed bath
involves washing the face, hands, underarms and genital/perineal area.
TUB BATH
Bathing should be a relaxing experience for the
client. Pay attention to safety considerations such as:
- The tub should be filled with an adequate amount of warm water (1050 F) to cleanse
the client.
- Never fill a tub deeper than waist deep.
- Place a bath mat or towel on the floor outside of the tub to prevent the client from
slipping on a wet floor when he steps out of tub.
- Do not leave the client unattended while in the tub.
Procedure for tub bath
 Gather necessary equipment.
 Ensure that the bathtub and bath chair are clean. If needed, clean the tub and chair with a
cleaning solution rinse according to the in-home provider’s policy.
  Place a nonskid mat, towel, or tub chair in the bathtub.
 Wash the hands and put on gloves if needed.
 If the client desires to undress in his room, provide privacy and assist the client to
undress and put on his robe and slippers.
 Ambulate or transfer by wheelchair to the bathroom.
 Fill the bath tub with 1050 F water at least half-full and check water temperature on the
inner surface of forearm.
 Assist the client to remove robe and slippers or undressed if he has not already done.
 Assist the client as needed in washing. If the client is unable to help, start with eyes then
wash face, ears, neck, arms, hands, chest, abdomen, and back. Ask the client if he wants
soap used on his face.
 Rinse the warm water.
 Wash legs, feet, and in between toes. Rinse with warm water and discard the washcloth.
 A shampoo may be given at this time. Cover the clients hair with a towel after shampoo
is completed.
 Ask or assist the client to turn slightly to one side. Wash peri area from front to back and
discard the washcloth in a laundry basket.
 Drain the bath tub.
 Remove and discard gloves if used.
 Uncover the client one area a time and pat dry with a towel.
SHOWER BATH
Clients with poor mobility or who have difficulty getting in and out of a bath tub may prefer
a shower bath.
Procedure for shower bath
 Gather necessary equipment.
 Keep bathroom at 750 -850 F and ensure that it is free from drafts to keep the client warm.
 Place a nonskid mat, towel, or tub chair in the bath tub.
 Wash hands and put on gloves if needed.
 Offer toileting.
 If the client desires to undress in his room, provide privacy and assist the client to
undress and put on his robe and slippers.
  Ambulate transfer by wheelchair to the bathroom.
 During the shower, keep the client under warm running water to help prevent chilling.
 If a shower is used, check it for sturdiness and adjust the height as needed.
SITZ BATH
A sitz bath is the process of soaking the perineal area (urethra to anus) in warm water. It
promotes healing of episiotomies, tears, fistulas or surgical sites. Sitz baths can provide pain
relief, relaxation, and wound healing by increasing blood flow to the area and cleansing the area.
SPONGE BATH
one in which the patient's body is not immersed but is wiped with a wet cloth or sponge; t
his is most often done for reduction of body temperature in presence of fever, in which case the
water used is cool.
BED BATH
DEFINITION
Bed bath the cleansing of a patient in bed. A complete bed bath indicates that someone
must totally wash a patient, as is done with an unconscious patient.
PURPOSES
 To clean the body off dirt and bacteria.
 To increase elimination through the skin.
 To prevent bed sore.
 To simulate circulation.
 To promote comfort to the patient.
 To regulate body temperature.
 To relieve fatigue.
 To provide active and passive exercise.
 To promote the feeling of wellbeing.
ARTICLES
 Mackintosh and 2 bed sheets Disposable gloves.
 Water basin (bowl) to hold the water for the bed bath.
 Soft, lightweight cotton or flannel blanket.
 Bath towel and wash cloth.
 Soap, powder, lotion, deodorant. Scissors and nail cutters
 comb, hairbrush and hair oil.
  mouth care supplies, such as toothbrush and toothpaste.
 Kidney tray and paper bag.
 Clothing, such as underwear and clean bedclothes or robe.
PROCEDURE:
1. Do hand washing and wear the gloves
2. To collect the equipment and arrange the items conveniently at the bed side.
3. Explain the procedure to the patient and get his cooperation.
4. Protect the bed with mackintosh and sheet.
5. Remove the patients linen and cover the patient.
6. Take water in the basin and feel with the back of hand. The temperature should be
comfortably hot.
7. With wet sponge towel, moisten the patient’s face first.
8. Apply soap. Carefully wash patient’s face, ears and front of the neck. Dry with the towel.
9. Remove the sheet up to the waist, ask the patients and keep the arms above his head. It
will be easy to clean the axillae in this position. Clean chest and abdomen.
10. Wash the left hand first and the right hand. Support patient’s arm by holding the wrist.
Wash well between fingers. The patient may place hands in basin.
11. Do the left leg first and then the right.
12. Change water and turn the patient to the side and sponge his back. Give long firm strokes
from back of neck to the buttocks. Watch for any redness over the pressure areas.
13. Apply powder if indicated. This depends upon the condition of the skin. If the skin is
wrinked the application of oils/creams is advisable.
14. Dress up the patient and remove the top sheet.
15. Remove the articles from the bed side.
16. Record and report to the procedure.